| Id Doc Llc | |
|
410 Foulk Rd Ste 105 Wilmington DE 19803-3835 | |
| (302) 295-9300 | |
| (302) 384-7162 |
| Full Name | Id Doc Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 410 Foulk Rd Ste 105, Wilmington, Delaware |
| Authorized Official Name and Position | Maya Gupta (OWNER) |
| Authorized Official Contact | 3022959300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Doc Llc 8 Pennock Dr Garnet Valley PA 19060-1400 Ph: (302) 295-9300 | Id Doc Llc 410 Foulk Rd Ste 105 Wilmington DE 19803-3835 Ph: (302) 295-9300 |
| NPI Number | 1902518939 |
|---|---|
| Provider Enumeration Date | 12/21/2022 |
| Last Update Date | 10/06/2023 |
| Medicare PECOS PAC ID | 7113398330 |
|---|---|
| Medicare Enrollment ID | O20230126002545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902518939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Maya Gupta |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811011646 PECOS PAC ID: 1052404878 Enrollment ID: I20070910000449 |
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